ALLERGIC DISEASES: ECZEMA AND DERMATITIS
Atopic eczema is principally a disease of infancy and childhood. ‘Atopic’ means the condition is likely to have been inherited; the disease often runs in families. Red itchy patches show first on the skin on the chin and cheeks, spreading next to the trunk. The creases around knees, wrists and ankles are also vulnerable. The skin is very itchy and the redness increases. Vesicles (blisters) can form which weep and bleed if scratched, and the skin can become infected, causing further complications. As children age, the skin can become thickened and leathery. In adults, the skin does not generally ooze but the skin is thickened. The condition in adults is often called dermatitis rather than eczema. Skin and blood tests for allergy are often negative in cases of eczema, but if there is a family history of allergy, and clear trigger factors are identified, allergy will be diagnosed.
In atopic contact dermatitis, the symptoms are very similar to those of atopic eczema, but they occur on the skin in the places where it has come into contact with the allergen. This is a different type of allergic reaction from the principal IgE reaction; it is often a delayed reaction, and can be reliably detected by patch testing.
In irritant eczema, the symptoms are again similar to atopic eczema and are caused by contact with substances such as washing powder, detergents, or occupational chemicals. In people with atopic eczema, such irritants can exacerbate their basic disease and need to be avoided even though they do not cause allergy. Like atopic eczema, irritant eczema will respond to treatment with moisturising creams and topical medication, whereas contact dermatitis invariably will not.
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